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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JERRY GEORGE IDICULA, M.ED., BCBA

Active

JERRY GEORGE IDICULA, M.ED., BCBA is a Behavior Analyst healthcare provider located in GROSSE POINTE PARK, Michigan. NPI 1356711766 is currently active in the NPPES registry. Verify at CMS.

Behavior Analyst · GROSSE POINTE PARK, MI

Registration Details

NPI Number
1356711766
Provider Type
Individual
Gender
Male
NPI Issued
Sep 28, 2015 (10.838252686412 yrs)
Last Updated
Mar 27, 2019
License
1-19-34854 (MI)

Practice Information

Address
1332 MARYLAND ST
GROSSE POINTE PARK, MI, 48230
Browse MI providers · Browse ZIP 48230
Phone
3132889458
Primary Specialty
Behavior Analyst
103K00000X

Other Behavior Analyst Providers in GROSSE POINTE PARK, MI

Name Credential NPI
RACHEL ENRIGHT 1598150583
CARLY STEINER M.ED, BCBA 1598123556
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.